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Difference between revisions of "Radical cystectomy grossing"
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The [[ureter]]s in these cases are often are assessed [[frozen section|intraoperatively]]. The occurrence of [[urothelial carcinoma in situ|CIS]] is strongly associated with CIS in the [[urinary bladder]].<ref name=pmid25374918>{{Cite journal | last1 = Zhou | first1 = H. | last2 = Ro | first2 = JY. | last3 = Truong | first3 = LD. | last4 = Ayala | first4 = AG. | last5 = Shen | first5 = SS. | title = Intraoperative frozen section evaluation of ureteral and urethral margins: studies of 203 consecutive radical cystoprostatectomy for men with bladder urothelial carcinoma. | journal = Am J Clin Exp Urol | volume = 2 | issue = 2 | pages = 156-60 | month = | year = 2014 | doi = | PMID = 25374918 }}</ref> | The [[ureter]]s in these cases are often are assessed [[frozen section|intraoperatively]]. The occurrence of [[urothelial carcinoma in situ|CIS]] is strongly associated with CIS in the [[urinary bladder]].<ref name=pmid25374918>{{Cite journal | last1 = Zhou | first1 = H. | last2 = Ro | first2 = JY. | last3 = Truong | first3 = LD. | last4 = Ayala | first4 = AG. | last5 = Shen | first5 = SS. | title = Intraoperative frozen section evaluation of ureteral and urethral margins: studies of 203 consecutive radical cystoprostatectomy for men with bladder urothelial carcinoma. | journal = Am J Clin Exp Urol | volume = 2 | issue = 2 | pages = 156-60 | month = | year = 2014 | doi = | PMID = 25374918 }}</ref> | ||
==Specimen opening== | |||
*Orientation: | |||
**Posterior - typically has serosa (shiny). | |||
**Uterus, uterine tubes and ovaries posterior to bladder. | |||
*Inking: | |||
**Urethra margin - green ink. | |||
**Anterior urinary bladder site of openning - green ink. | |||
***Line 1: anterior bladder base toward upper left. | |||
***Line 2: anterior bladder base toward upper right. | |||
**If total hysterectomy - soft tissue margin - black ink | |||
*Opening: | |||
**Open anteriorly through the urethra and follow the ink upward to left and upward to right - such that anterior bladder wall can be flipped upward. | |||
**Open the uterus - if present - with sissors through the external os with cuts on the lateral walls. | |||
*Specimen should be pinned open on a large block of paraffin wax. | |||
**A paper towel should be placed behind the specimen - between the specimen and paraffinx wax. | |||
*Place specimen(s) in [[formalin]]. | |||
==Protocol== | ==Protocol== | ||